A randomized wait-list controlled trial of feasibility and efficacy of an online mindfulness-based cancer recovery program: the eTherapy for cancer applying mindfulness trial.

OBJECTIVE: A treatment-as-usual randomized wait-list controlled trial was conducted to investigate the feasibility and impact of an online synchronous Mindfulness-Based Cancer Recovery (MBCR) group program for underserved distressed cancer survivors. METHODS: Sixty-two men and women exhibiting moderate to high distress within 3 years of completing primary cancer treatment without access to in-person MBCR were randomized to either immediate online MBCR (n = 30) or to wait for the next available program (n = 32). Participants completed questionnaires preintervention and postintervention or wait period online. Program evaluations were completed after MBCR. Feasibility was tracked through monitoring eligibility and participation through the protocol. Intent-to-treat mixed-model analyses for repeated measures were conducted. RESULTS: Feasibility targets for recruitment and retention were achieved, and participants were satisfied and would recommend online MBCR. There were significant improvements and moderate Cohen d effect sizes in the online MBCR group relative to controls after MBCR for total scores of mood disturbance (d = 0.44, p = .049), stress symptoms (d = 0.49, p = .021), spirituality (d = 0.37, p = .040), and mindfully acting with awareness (d = 0.50, p = .026). Main effects of time were observed for posttraumatic growth and remaining mindfulness facets. CONCLUSIONS: Results provide evidence for the feasibility and efficacy of an online adaptation of MBCR for the reduction of mood disturbance and stress symptoms, as well as an increase in spirituality and mindfully acting with awareness compared with a treatment-as-usual wait-list. Future study using larger active control RCT designs is warranted. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01476891.

Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial.

BACKGROUND: Irritable bowel syndrome (IBS) is a functional disorder of the lower gastrointestinal (GI) tract affected by stress, which may benefit from a biopsychosocial treatment approach such as mindfulness-based stress reduction (MBSR). PURPOSE: A treatment as usual (TAU) wait-list controlled trial was conducted in Calgary, Canada to investigate the impact of MBSR on IBS symptoms. It was hypothesized that MBSR patients would experience greater reduction in overall IBS symptom severity and self-reported symptoms of stress relative to control patients. METHOD: Ninety patients diagnosed with IBS using the Rome III criteria were randomized to either an immediate MBSR program (n = 43) or to wait for the next available program (n = 47). Patients completed IBS symptom severity, stress, mood, quality of life (QOL), and spirituality scales pre- and post-intervention or waiting period and at 6-month follow-up. Intent-to-treat linear mixed model analyses for repeated measures were conducted, followed by completers analyses. RESULTS: While both groups exhibited a decrease in IBS symptom severity scores over time, the improvement in the MBSR group was greater than the controls and was clinically meaningful, with symptom severity decreasing from constantly to occasionally present. Pre- to post-intervention dropout rates of 44 and 23 % for the MBSR and control groups, respectively, were observed. At 6-month follow-up, the MBSR group maintained a clinically meaningful improvement in overall IBS symptoms compared to the wait-list group, who also improved marginally, resulting in no statistically significant differences between groups at follow-up. Improvements in overall mood, QOL, and spirituality were observed for both groups over time. CONCLUSIONS: The results of this trial provide preliminary evidence for the feasibility and efficacy of a mindfulness intervention for the reduction of IBS symptom severity and symptoms of stress and the maintenance of these improvements at 6 months post-intervention. Attention and self-monitoring and/or anticipation of MBSR participation may account for smaller improvements observed in TAU patients.

The eCALM Trial-eTherapy for cancer appLying mindfulness: online mindfulness-based cancer recovery program for underserved individuals living with cancer in Alberta: protocol development for a randomized wait-list controlled clinical trial.

BACKGROUND: Elevated stress can exacerbate cancer symptom severity, and after completion of primary cancer treatments, many individuals continue to have significant distress. Mindfulness-Based Cancer Recovery (MBCR) is an 8-week group psychosocial intervention consisting of training in mindfulness meditation and yoga designed to mitigate stress, pain, and chronic illness. Efficacy research shows face-to-face (F2F) MBCR programs have positive benefits for cancer patients; however barriers exist that impede participation in F2F groups. While online MBCR groups are available to the public, none have been evaluated. PRIMARY OBJECTIVE: determine whether underserved patients are willing to participate in and complete an online MBCR program. SECONDARY OBJECTIVES: determine whether online MBCR will mirror previous efficacy findings from F2F MBCR groups on patient-reported outcomes. METHOD/DESIGN: The study includes cancer patients in Alberta, exhibiting moderate distress, who do not have access to F2F MBCR. Participants will be randomized to either online MBCR, or waiting for the next available group. An anticipated sample size of 64 participants will complete measures online pre and post treatment or waiting period. Feasibility will be tracked through monitoring numbers eligible and participating through each stage of the protocol. DISCUSSION: 47 have completed/completing the intervention. Data suggest it is possible to conduct a randomized waitlist controlled trial of online MBCR to reach underserved cancer survivors. TRIAL REGISTRATION: Clinical Trials.gov Identifier: NCT01476891.

The association between earlier age of first drink, disinhibited personality, and externalizing psychopathology in young adults.

Earlier age of first drink (AFD) of alcohol is associated with higher rates of alcohol abuse and dependence as well as a range of other externalizing problems. This study tested the hypotheses that in young adults earlier AFD is associated with [1] the common variance among externalizing problems (lifetime alcohol, marijuana, other drug, childhood conduct, and adult antisocial behavior problems) rather than being uniquely associated with alcohol problems, and [2] the disinhibited personality traits of social deviance and impulsivity, and that the association between earlier AFD and externalizing problems is partly accounted for by disinhibited personality. The sample (N=502) included 299 young adults with a history of alcohol dependence (AD) and 203 subjects with no history of AD. Analyses showed that [1] earlier AFD was associated with the covariance among the different domains of externalizing problems and was not unique to any one externalizing problem, [2] earlier AFD was associated with social deviance and impulsivity, and [3] social deviance and impulsivity accounted for part of the association between earlier AFD and externalizing problems. The results suggest that earlier AFD is associated with a vulnerability to disinhibitory disorders and is not specifically associated with alcohol problems.